<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Mold')}:</label>
        <div class="col-xs-12 col-sm-8">
                        
            <select  id="c-mold" data-rule="required" class="form-control selectpicker" name="row[mold]">
                {foreach name="moldList" item="vo"}
                    <option value="{$key}" {in name="key" value="$row.mold"}selected{/in}>{$vo}</option>
                {/foreach}
            </select>

        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('From_user_group_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-from_user_group_id" data-rule="required" data-source="from/user/group/index" class="form-control selectpage" name="row[from_user_group_id]" type="text" value="{$row.from_user_group_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('From_user_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-from_user_id" data-rule="required" data-source="from/user/index" class="form-control selectpage" name="row[from_user_id]" type="text" value="{$row.from_user_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('To_user_group_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-to_user_group_id" data-rule="required" data-source="to/user/group/index" class="form-control selectpage" name="row[to_user_group_id]" type="text" value="{$row.to_user_group_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('To_user_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-to_user_id" data-rule="required" data-source="to/user/index" class="form-control selectpage" name="row[to_user_id]" type="text" value="{$row.to_user_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Order_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-order_id" data-rule="required" data-source="order/index" class="form-control selectpage" name="row[order_id]" type="text" value="{$row.order_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Claim_shop_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-claim_shop_id" data-rule="required" data-source="claim/shop/index" class="form-control selectpage" name="row[claim_shop_id]" type="text" value="{$row.claim_shop_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('User_coupon_exchange_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-user_coupon_exchange_id" data-rule="required" data-source="user/coupon/exchange/index" class="form-control selectpage" name="row[user_coupon_exchange_id]" type="text" value="{$row.user_coupon_exchange_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Amount')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-amount" class="form-control" step="0.01" name="row[amount]" type="number" value="{$row.amount|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Brokerage')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-brokerage" class="form-control" step="0.01" name="row[brokerage]" type="number" value="{$row.brokerage|htmlentities}">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
